Author-Dr Aparna Pandya (Mrs India Vivacious 2019)

The frenum is a connective tissue membrane that attaches one surface within the mouth to another. There are two types of frenulums- lingual frenulum and labial frenulum.

Lingual Frenulum is located at the base of the tongue and the bottom of the mouth. Lingual frenulums are of different sizes, and the attachment to gingiva may vary in some cases.

Labial Frenulum is a frenulum that connects the lip to the gums. When a frenulum is too wide or long, it can produce a space between the two frontal teeth and other dental issues.

Frenectomy

A frenectomy, according to the American Association of Oral and Maxillofacial Surgeons, is a simple surgical procedure where an oral surgeon releases the frenulum bands or removes them. Labial frenectomy helps close the gap in the frontal teeth.

Frenotomy versus Frenectomy

Issues with the labial frenulum may lead to root exposure, gaps between teeth and dental hygiene problems, as the frenulum might the gingiva down from the teeth. Orthodontic treatment maybe suitable to close the gap in teeth; and bone problems may develop. Issues with the lingual frenulum may lead to restrictions in the mobility and movement of your tongue, which could beget changes in tooth position, speech, and jaw development. This condition is present at birth and is constantly called ankyloglossia or" tongue- tie," and can beget issues with nursing in babies and talking with children.

The abnormal frena are detected visually by applying tension over the frenum to see the movement of the papillary tip or the blanch which is produced due to ischaemia in the region. The frenum is characterized as pathogenic when it is unusually wide or when there is no apparent zone of the attached gingiva along the midline or the interdental papilla shifts when the frenum is extended.

A typical frenotomy only requires a numbing gel, and conceivably an anesthetic. During the procedure, the frenulum is simply cut with sterile scalpel. There's generally little to no blood after the cut, and in the case of a lingual frenotomy for babies, babies can breastfeed incontinently.

A frenectomy, while still a simple procedure, is a more involved surgery due to the complete excision of the frenulum, and painkillers will be prescribed. It is critical to provide proper and clear pre and post-operative instructions so that the patient have a safe procedure and comfortable frenectomy recovery.

These days the use of lasers are widely popular due to the several advantages associated with the procedure such as faster recovery, bloodless and painless procedure and lesser post-operative complications as compared to the conventional scalpel technique. Electrocautery usage is also common for frenum removal procedures. This procedure also offers several advantages such as less bleeding, ease of execution, and faster recovery. It takes between two or three weeks for the surgical site to heal completely. A laser frenectomy/ electrocautery has an even shorter recovery period.

A frenectomy and frenotomy help to exclude conditions in the mouth that may lead to oral health issues, and eventually lead to long- term positive change.